PRECEDE-PROCEED model modification in community-based oral health promotion by using the linear structural relations...

Area of Science:

• Health Education
• Public Health
• Health Promotion Program Design

Background:

• The PRECEDE-PROCEED (P-P) model is a widely used framework for designing health education and promotion programs.
• While applied to community oral health, its outcome assessments are infrequently reported.
• This study addresses the need to validate the P-P model's pathways in a specific cultural context.

Purpose of the Study:

• To evaluate the accuracy of the P-P model's pathways in assessing environmental and behavioral factors in a Japanese community.
• To determine if using the Linear Structural Relations (LISREL) program can enhance the P-P model's fit and predictive power.

Main Methods:

• A questionnaire on oral health was administered to 824 mothers with 3-year-old children in a Japanese community health center.
• Data were compiled into eight variables and analyzed using the LISREL program.
• Goodness-of-fit indices (GFI, AGFI, RMSEA) were calculated before and after modifying the P-P model.

Main Results:

• The modified P-P model demonstrated significantly improved fit indices (GFI: 0.975, AGFI: 0.939, RMSEA: 0.075) compared to the initial model (GFI: 0.913, AGFI: 0.776, RMSEA: 0.161).
• Indirect effects on quality of life from predisposing, reinforcing, and enabling factors were strengthened in the modified model.
• The original P-P model did not accurately represent the community's environmental and behavioral assessment status.

Conclusions:

• The modified P-P model accurately reflects the current environmental and behavioral assessment status within the studied Japanese community.
• Rigorous testing and adaptation of health education models are crucial to ensure alignment with real-world behaviors and contexts.